The EMI plan was designed for CCSD employees and eligible retirees that reside in the rural areas of Clark County, including Mesquite and Logandale, as well as neighboring regions in Utah and Arizona. Although the EMI plan is no longer open to new members, its existing participants are grandfathered into this plan. EMI plan members can elect to move into our other plans during an open enrollment period.
Visit EMIHealth.com or download the EMI Health to manage all your benefits in one place.
Using in- network providers and facilities gets you the most coverage for healthcare services and saves you money.
As a member of EMI Health, you have access to the nationwide Cigna PPO network of doctors, hospitals, and other facilities. You have access to in-network providers everywhere you go in the United States, helping you save money and protecting you from getting balance billed.
You’ll see your provider search results and you’ll be able to see where the providers/facilities are located, specialties, and other useful information to help you make your healthcare decisions.
70%of doctor visits can be handled over the phone, and 40%of urgent care visits can be managed using TeleMedicine. Save time and money while still getting the treatment you need through EMI Health TeleMed offered through Recuro.
Recuro doctors diagnose acute, non- emergent medical conditions and prescribe medications when clinically appropriate.
Speak with a doctor anytime and pay no consultation fee rather than paying the high costs associated with office visits, urgent care visits, and emergency room visits. Doctors are available by phone 24/7 and by video calls from 7 AM – 7 PM.
This benefits guide offers a wealth of information on your health benefits with Teachers Health Trust and EMI Health. From detailed coverage insights to wellness tips and updates, this resource empowers you to make informed decisions for your well-being.
Members on this plan are eligible for a Flexible Savings Account (FSA) through American Fidelity.
COBRA payments are managed exclusively by WEX Inc. For more information, visit the COBRA page.
The EMI Plan is a traditional PPO plan with set copays and deductibles residing in Clark and Nye County. THT does not require a referral to see a specialist, however, the specialist may require one. All services are subject to the EMI Health Maximum Allowable Charge. When using a Non-participating Provider, the Covered Person is responsible for all fees in excess of the Maximum Allowable Charge.
Members on the EMI plan are on a calendar year, meaning that deductibles reset annually on January 1. Additionally, they will have their own open enrollment period separate from the general membership. The EMI Open Enrollment typically takes place in November.
| In-Network | Out-of-Network | |
|---|---|---|
| General Information | ||
| Annual Out-of-Pocket Maximum Individual / Family |
$7,500 / $15,000 | $7,500 / $15,000 |
| Annual Medical Deductible Individual / Family |
$500 / $1,500 | $1,500 / $4,500 |
| Physician & Professional Services | ||
| Convenience Clinic | $40 | 50% |
| Primary Care | $15 | 50% |
| Secondary Care | $30 | 50% |
| Physician Visits | 20% | 50% |
| Surgery | 20% | 50% |
| Anesthesiology | 20% | 50% |
| Rehabilitation Therapy | $30 | 50% |
| Chiropractic Therapy | $30 | 50% |
| Acupuncture Services | $30 | 50% |
| Allergy Testing | 20% | 50% |
| Hospital/Facility Benefits | ||
| Medical/Surgical Care (Outpatient) | 20% | 50% |
| Emergency Room (ER) | $300 | $300 |
| Urgent Care Clinic | $30 | 50% |
| Preventive Care | 0% | 0% |
| In-Network (Advantage Plus Network) |
In-Network (Premier Network) |
Out-of-Network | |
|---|---|---|---|
| Type 1 – Preventive Oral Exams, Cleanings, X-rays, Fluoride |
100% | 100% | 100% up to MAC* |
| Type 2 – Basic Fillings, Oral Surgery, Endodontics, periodontics, Sealants, Space Maintainers |
80% | 80% | 80% up to MAC* |
| Type 3 – Major Crowns, Bridges, prosthodontics |
60% | 60% | 60% up to MAC* |
| Type 4 – Orthodontics Dependent children ages 7 through 18 |
50% | 50% | 50% up to MAC* |
| Adults | Discount Only | Discount Only | No Coverage |
| Annual Maximum Per Person | $2,000 | $1,500 | $1,500 |
*All Services are subject to EMI Health Maximum Allowable Charge (MAC). When using a Non-participating Provider, the insured is responsible for all fees in excess of the Maximum Allowable Charge (MAC
| In-Network | Out-of-Network | |
|---|---|---|
| WellVision Exam | $10 Copay | Up to $65 |
| Lenses (Glass or Plastic) | ||
| Single Vision | $10 Copay | Up to $30 |
| Lined Bifocal | $10 Copay | Up to $50 |
| Lined Trifocal | $10 Copay | Up to $65 |
| Lenticular | $10 Copay | Up to $100 |
| Lens Options | ||
| Progressive (Standard no-line) | $0 Copay | Up to $50 (In lieu of Lined Bifocal reimbursement) |
| Premium Progressive Options | $95-$105 Copay | Up to $50 (In lieu of Lined Bifocal reimbursement) |
| Custom Progressive Options | $150-$175 Copay | Up to $50 (In lieu of Lined Bifocal reimbursement) |
| Plastic Gradient Dye | $17 Copay | N/A |
| Solid Plastic Dye | $15 Copay | N/A |
| Photochromic Lenses | $75 Copay | N/A |
| Polycarbonate for Adults | $31 Copay SV/$35 Copay Multifocal | N/A |
| Polycarbonate for Children (under 18) | $0 Copay | N/A |
| Coatings | ||
| Scratch Resistant Coating | $17 Copay | N/A |
| Anti-Reflective Coating | $41 Copay | N/A |
| UV Protection | $16 Copay | N/A |
| Additional lens enhancements | Up to 25% Discount | N/A |
| Frames | ||
| Allowance Based on Retail Pricing | $130 Allowance at any VSP doctor or $70 at Costco, Sam’s Club or Walmart |
Up to $80 |
| Additional Pairs of Glasses** | Up to 20% Off Retail | N/A |
| Elective Contact Lenses In Lieu of Frame & Lenses | ||
| Elective contact lens fitting, evaluation services and prescription contact lenses are covered up to plan allowance. 15% discount given off contact lens fitting and evaluation services, excluding materials. | $130 Allowance | Up to $115 |
| Frequency | ||
| Exam, Lenses, Frame or Contacts | ||
| Refractive Surgery | Up to $500 in Savings | Not Covered |
This is a summary of plan benefits. The actual Policy will detail all plan limitations and exclusions** 20% discount off unlimited additional pairs of glasses offered through any VSP Choice Providers within 12 months of last covered eye exam.*** Discounts average 15-20% off or 5% off a promotional offer for laser surgery, including PRK, LASIK, Custom LASIK, and IntraLase3
| Participating Pharmacy (up to 30 day supply) |
Non-Participating Pharmacy | Mail Order (up to 90 day supply) |
|
|---|---|---|---|
| Generic | $15 | Not Covered | $40 |
| Preferred | 25%, up to $100 | Not Covered | 25%, up to $300 |
| Non-Preferred | 40% | Not Covered | 40% |
| Specialty Pharmacy (up to 90 day supply) All fills must be purchased through Express Scripts Specialty Pharmacy. |
25%, up to $1,500 | n/a | n/a |
| Specialty Pharmacy SaveOnSP Program 1-800-683-1074 http://emihealth.com/pdf/saveon.pdf |
$0 Copay After Enrolling | n/a | n/a |
Sierra Healthcare Options (SHO) Network
